I don’t know about you, but getting a blood test used to be as easy as going to your favourite lab, getting your arm poked (ouch!), not watching the red fluid ease up the tube, ripping off the band-aid, waiting for the test results, getting a copy from your GP, and then reading the name of the lab at the top and then all the info underneath. Well, the bureaucrats have improved it.
First off, your favourite lab may now be out of bounds: Your doctor insists you go to his favourite lab or yours may have new rules about who can see them. The Toronto General Hospital (TGH) has the best vampires bar none, but since a year ago, they test only those who have TGH-based doctors. So now I get to choose between labs that don’t believe in using butterfly needles (or even know what they are), are a bit laissez faire about the whole hygiene thing, treat you like a number, or set it up to ease germs getting human passage from one place to another (yes, Mount Sinai hospital I’m talking about you with your gross number machine).
And second, the lab you went to may not be the lab that tests your fluids. Huh, I can hear you ask? Yes, the lab that pokes your arm is not the lab that tests your blood. The lab name at the top of the results sheet is where you went; now insterspersed among the information below are the names of the labs where your blood went. Which begs the question: if I go to private Lab A who then sends my blood to TGH, why the heck couldn’t I have gone to TGH in the first place?! The real killer for me though was the 24-hour urine test.
So OK, doctors at Mount Sinai like me to use the dirty-waiting-seat-gross-number-machine-averse-to-butterfly-needles lab there cause they like consistent results from one lab, the lab they know and trust, the Mount Sinai lab. I had wanted to use TGH, got my way with the doctor, but then TGH promptly said nah-uh, yet gave me the, ahem, testing jugs. I brought them to Mount Sinai, and the lady behind this enormous counter, the back of which she couldn’t reach and was the part closest to me, said, “don’t put that on my desk!” as I rested the jug inside a closed bag, inside a shopping bag (see, those plastic bags have uses) on the back of the desk. Yet she takes those number slips from patients’ hands. Go figure. Then she’s not sure Mount Sinai can test those jugs cause, well, they’re not Mount Sinai jugs. Oh brother. After much toing and froing, warnings and admonishments, and me pasting on of labels, I’m free to leave them as far away from her as I possibly can. I don’t remember any other lab person being so finicky, but then those labs call you by name and don’t have germy number machines. So weeks later, I get the test results back. Guess what? Mount Sinai did none of the testing. Nope, none. Two other hospitals did, one of which was Sick Kids. Sick Kids???
So, what the heck was all that botheration about? Does it really matter where I go? Does TGH’s new restrictive policy really make a difference to its workload when Gamma-Dynacare sends blood to them for testing, when at least one hospital doesn’t even do all its own testing, when bodily fluids are now making the downtown rounds in vans and trucks on public roads from one place to another, from one hospital to another? (Yes, that medical lab van next to you has blood in it. Don’t hit it now!) And I have to wonder about how consistent results can be over time with this merry-go-round testing when some doctors claim that tests are so sensitive that the variation between labs can cause them to prescribe incorrect medication levels and that’s why they want you to go to the same lab, their lab. Their preference is also true for other kinds of testing, but I’ve recently noticed that stress test reports vary markedly from one place to another, such that a complete report from one place makes you notice how incomplete the summary report is from Mount Sinai.
It seems to me that the bureaucrats and bean counters have created jobs for themselves by taking over the medical labs; they are not only costing us good customer service, but may also be skewing results due to lab variation unbeknownst to the doctors who blissfully still count on their own lab to do all the testing. It used to be I didn’t think about the testing labs; I assumed they were all good. But now I wonder. I wonder too if I need to acquaint myself with which labs are good and which not, which labs test my samples, and which outsource. And I also wonder when it comes to tests of all kinds, how good is my health care, really?